Uma etnografia virtual em um grupo sobre o transtorno bipolar: sociabilidades e saberes produzidos no meio on-line / Virtual ethnography in a group about bipolar disorder: sociabilities and knowledge produced in the online environment / Una etnografía virtual en un grupo sobre el trastorno bipolar: sociabilidades y saberes producidos en el medio on-line

Publicado pela primeira vez no Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM) III, o transtorno bipolar trouxe uma nova maneira de entender e vivenciar as oscilações emocionais, fortemente imbuída dos referenciais da psicofarmacologia, neurociências e novas conceituações sobre as variações afetivas. Com o objetivo de investigar os sentidos, as sociabilidades e os modos de ser constituídos a partir desse diagnóstico, foi feita uma etnografia no grupo brasileiro do Facebook mais numeroso sobre a bipolaridade, que identificou o seguinte: a rede facilita a produção de uma expertise experiencial; a ideia de que "apenas quem sofre entende" fortalece a identificação mútua; em contraposição à antiga psicose maníaco-depressiva, o transtorno bipolar adquire certa positividade, tornando-se fonte de humor; a química medicamentosa é o principal recurso usado para gerir a vida afetiva, tornando os pacientes parcialmente independentes do médico ao manejarem esses recursos entre si; e o transtorno bipolar é dissociado do Eu.(AU)

Published for the first time in DSM IIII, bipolar disorder has brought a new way of understanding and experiencing emotional oscillations, strongly impregnated with the frameworks of psychopharmacology, neurosciences, and with new conceptualizations of affective variations. Aiming to investigate the meanings, sociabilities and ways of being constituted from this diagnosis, an ethnography was performed in the most numerous Brazilian Facebook group about bipolar disorder, which identified the following aspects: the network facilitates the production of an experiential expertise; the idea that "only those who suffer from it can understand it" strengthens mutual identification; in opposition to manic depression, as it was formerly called, bipolar disorder acquires a certain positivity, becoming a source of humor; drug therapy is the main resource used to manage affective life, making patients partially independent from the physician when they handle these resources among themselves; bipolar disorder is dissociated from the "self".(AU)

Publicado por primera vez en el DSM III, el trastorno bipolar proporcionó una nueva manera de entender y experimentar las oscilaciones emocionales, fuertemente basada en los referenciales de la psicofarmacología, neurociencias y nuevas conceptuaciones sobre las variaciones afectivas. Con el objetivo de investigar los sentidos, sociabilidades y modos de ser constituidos a partir de este diagnóstico, se realizó una etnografía en el grupo brasileño del Facebook más numeroso sobre la bipolaridad que identificó lo siguiente: la red facilita la producción de una expertise con base en la experiencia; la idea de que "solamente quien lo sufre entiende" fortalece la identificación mutua; en contraposición a la antigua psicosis maníaco-depresiva, el trastorno bipolar adquiere cierta positividad, convirtiéndose en fuente de humor; la química medicamentosa es el principal recurso utilizado para administrar la vida afectiva, haciendo que los pacientes sean parcialmente independientes del médico al manejar estos recursos entre sí; el trastorno bipolar se disocia del "yo".(AU)

Las condiciones del cuidado en familias antioqueñas con un miembro con trastorno afectivo bipolar / Context of the care provided to a family member with bipolar disorder in Antioquia, Colombia

El presente artículo informa acerca de la investigación ''Prácticas de cuidado y carga familiar en familias antioqueñas con un miembro diagnosticado con trastorno afectivo bipolar''. Objetivo: reconocer las condiciones en que se da el cuidado de un miembro diagnosticado con dicho trastorno en un grupo de familias antioqueñas. Método: el enfoque del estudio fue cualitativo; la metodología fue la fenomenológica-hermenéutica. Participaron 12 familias a las que se hicieron entre dos y tres entrevistas en profundidad y se construyó el familiograma. Resultados: existen dos ejes explicativos del aumento del estrés y el agotamiento familiares alrededor del cuidado de un enfermo mental: la vía del cuidador y la vía de las condiciones materiales e inmateriales del cuidado. Conclusiones: (1) el estrés y el agotamiento del cuidador de un enfermo mental son bajos cuando él mismo elige serlo y se narra como tal; (2) la calidad y el tipo de vínculo establecido entre el cuidador y el enfermo son fuertes predictores del estrés y el agotamiento familiares; (3) la enfermedad pone a prueba la identidad de la familia y la de cada uno de sus miembros.

This article is a report on the research ''Care practices and family burden in families from Antioquia, Colombia, with a member diagnosed with bipolar affective disorder''. Objective: To recognize the context of the care provided to family members diagnosed with such disorder. Method: a qualitative study using the phenomenological and hermeneutic approach was done. Data were collected via in-depth interviews with the 12 families participating in the study, and a genogram was built. Results: two factors explain the increased stress and fatigue observed in family members taking care of a person with a mental condition: the first one is associated with the caregiver, and the second one, with the material and immaterial conditions of the care provided. Conclusions: (1) stress and fatigue are low when individuals willingly choose to take care of the person with a mental condition and thus define themselves as caregivers; (2) the quality and type of the bond established between the diseased person and the caregiver are strong predictors of family stress and fatigue; (3) this condition challenges the identity of the family and that of each one of its members.

Farmacología del epigenoma: investigaciones sobre usos de utilidad clínica de drogas estabilizantes del ánimo/anticonvulsivantes / Pharmacology of the epigenome: investigations on the use of clinical utility, of mood stabilizers/anticonvulsants

La epigenética es un promisorio campo de la investigación que probablemente contribuya a la comprensión de un amplio rango de enfermedades como la ansiedad, la depresión, la esquizofrenia, la enfermedad de Alzheimer, la enfermedad de Huntington o el síndrome de Rett. Esta área del conocimiento se refiere a las modificaciones en la expresión genética que resultan en cambios heredables y que son independientes de los cambios de la secuencia genética. Esto incluye la metilación del ácido desoxirribonucleico (ADN), las modificaciones de las histonas y más recientemente a la interferencia del ácido ribonucleico (ARN), especialmente a través de la no traducción a proteínas por microARN (miARN) u otros ARN pequeños de interferencia (SIRNA´s). La farmacología de la epigénetica está avanzando en el desarrollo de drogas o probando las utilizadas para otras indicaciones, para modificar las alteraciones del epigenoma que resultan en enfermedades o vulnerabilidades a diversas patologías.Los inhibidores de la deacetilasa de las histonas son un ejemplo de lo anteriormente expuesto. Demostraron tener eficacia como anticancerosos a través de un amplio rango de enfermedades malignas, especialmente las hematológicas. El valproato, un inhibidor de la deacetilasa de las histonas, es una droga que ha sido utilizada por décadas para tratar la epilepsia, los trastornos del estado de ánimo y la migraña y actualmente se lo investiga para otras indicaciones.El objetivo de este capítulo es mostrar los avances realizados en el conocimiento de los mecanismos de acción de drogas utilizadas como estabilizantes del estado de ánimo/anticonvulsivantes, como también sus probables usos por fuera de su indicación específica.

Epigenetics is a promising field of research, which probably contributes to understanding a wide spectrum of disorders such as anxiety, depression, schizophrenia, Alzheimer's Disease, Huntington's Disease or Rett's Syndrome. This area of knowledge refers to modifications in the gene expression, which result in inheritable changes and which are independent of the changes in the gene sequencing. This includes the methylation of deoxyribonucleic acid (DNA), the changes of histones, and, more recently, the role of ribonucleic acid (RNA), particularly, by means of non-protein-coding RNA (miRNA) or other small interfering RNA's (SIRNA's). The pharmacology of epigenetics is progressing in terms of the development of drugs, or the testing of the already used ones form other indications, in order to modify the alterations in the epigenome that result in diseases or vulnerabilities to different pathologies. Histone decetylase inhibitors are an example of the above. They prove to be effective against cancer through a wide spectrum of malignant diseases, especially hematologic diseases. Valprotate, a histone deacetylase inhibitor, is a drug which has been used for decades to treat epilepsy, mood disorders and migraines, and is currently being researched for other indications as well. The purpose of this chapter is to show the advances achieved with respect to the knowledge of the mechanisms of action of drugs used as mood stabilizers/anticonvulsants, as well as their possible uses beyond their possible uses beyond their specific indication.

Gender and ethnicity in first admissions to a psychiatric unit in Trinidad

It has been recognized that there are gender disparities in the admission rates to psychiatric units. While the community prevalence of the major non-organic psychotic mental disorders are thought to have no gender bias, non-psychotic disorders such as depression are more commonly diagnosed in women. Gender differences in admission may indicate differences in severity or in presentation to psychiatric services and would have important implications for the targeting of preventative strategies. The case notes of all admissions to the psychiatric unit at the San Fernando General Hospital were obtained for the calendar year 1999. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnoses and gender were analysed to determine the distribution of diagnostic categories by gender. A total of 119 patients were admitted to the unit for the first time in the period under review, 72 were male (60.5) and 47 were female (39.5). There were no significant differences in age by gender. Substance use related admissions and psychotic illnesses (schizophrenia spectrum and affective psychoses) were significantly more common in men (p = 0.006; p = 0.03 respectively). These differences were especially marked for those of East Indian descent. Non-psychotic illnesses were more commonly diagnosed among women (p = 0.0008). These findings suggest that a larger proportion of males are admitted to the general hospital psychiatric unit among first time admissions. This is also true for re-admissions. Men are more likely to be diagnosed with substance use and psychotic disorders, while for women, major depression and non-psychotic illnesses are the main diagnoses. Community surveys are needed to determine whether this demographic pattern of admission reflects the population prevalence of these disorders. Reduction of admission rates will require interventions that are sensitive to gender differences in diagnosis among those admitted to psychiatric units